Kenneson, Michael J

Kenneson, Michael J is an individual health care provider with primary practice located at 42645 Garfield Rd Suite 103, Clinton Twp MI 48038-5022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kenneson, Michael J can be contacted via phone (586) 286-0050.

Contact Information

Primary practice address
42645 Garfield Rd Suite 103 Clinton Twp MI 48038-5022
Phone: (586) 286-0050
Fax: (586) 286-0880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101010986 Michigan

Profile Details

NPI number 1154391969
LBN Legal business name Kenneson, Michael J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jun 11th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154391969 NPPES
Michigan MEDICAID 4381308
Michigan MEDICAID 4991989

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